Clinical And Experimental Research On The Effectiveness Of Using "Xian Yu Tang" Chinese Medicine To Improve Quality Of Life For Elder Lung Cancer Patients

Background for this researchLung cancer refers to primary bronchogenic carcinoma.It had been recorded in the ancient Chinese medicine book long time ago and was defined as "Feiji","Feiyan","Xipen" and other medical terms.It is the most common cancer among all kinds of malignant carcinoma.With high fatal rate.Due to its high degree of complicate pathology,recovery rate is very low.In recent years,there is a trend of high growing rate in the new cases.Most new patients are elder people;therefore lung cancer is also named as "cancer of elders" by some people.Up to now,there are 3 main treatments for lung cancer;including surgery,chemotherapy,and radiotherapy.The introduction of target therapy in recent years is a breakthrough in the treatment for cancer but cost is highly expensive.However,as symptoms of most elder lung cancer patients are not obvious,it usually overlooked in the diagnosis by doctors.Besides,due to the poor physical conditions of elder patients,together with lower degree of tolerance to strong medical treatments and higher possibility of complication,selection of therapeutic regimens is not an easy task.Clinical evidence over past years proves that application of Chinese medicine combined with chemotherapy can strengthen the treatment effectiveness while reducing the negative side effect of western medicine,improving the quality of life for patients.Recently,integration of TCM and western medicine for curing lung cancer has become an important research topic in the medicine field.For many years in clinical trial,the Chinese herbal medicine "Xian Yu Tang" developed by Professor Chen Riu Shen of the Guangzhou University of TCM has been proven to be effective for curing lung cancer in terms improving symptoms and extending survival period.Purpose of this researchThe purpose of this research is to evaluate the quality of life for elderly lung cancer patients of age at 65 or above by the treatment of "Xian Yu Tang" as compare to another two groups using chemotherapy and combination of "Xian Yu Tang" and chemotherapy respectively.Method of this researchThis research contains 2 parts;clinical study in hospitals and animal experiment in laboratory.(1)The clinical studySelect 90 lung cancer patients of age at 65 or above from the in-patients departments and out-patients departments in the 1^stAffiliated Hospital of Guangzhou TCM University and the Main PLA Hospital in Guangzhou.The selected patients are divided into 3 groups of 30 in each.GroupⅠpatients were treated purely by Chinese Medicine "Xian Yu Tang ",GroupⅡpatients were treated purely by chemotherapy,while groupⅢpatients were treated by the combination of "Xian Yu Tang" and chemotherapy.The research instruments mainly used in this research including the internationally recognized EORTC QLQ-C30 and QLQ-c=LC13 developed by the European Cancer Research and Treatment Organization.In addition,the change of Chinese medicine symptoms,Karnofsky rating,size of the tumor,body weight and negative reactions in blood,kidney and liver functions after the treatment were also taken into consideration to evaluate the quality of life.(2)Animal experimcntThe purpose is to observe how the application of "Xian Yu Tang " with chemotherapy affect the expression of TNF-αin the mice with Lewis lung cancer cell.The method is to inoculate into 50 mice then divide these mice equally into 5 groups.;(1)."Xian Yu Tang "group,(2).combination of "Xian Yu Tang" and chemotherapy.Group,(3).Chemotherapy group,(4)Model group and(5).Empty group.With different kinds of medical treatments After 21 days all mice were killed.Then use FQ-PCR techniques to evaluate the expression of.TNF-αin the mice of each group.Results of the studiesThe clinical study covers 90 patients.30 in the The."Xian Yu Tang "group (20 male,10 female).30 in the Chemotherapy group(17 male,13 female), 30 in the Combination group(19 male,11 female).The Average ages for these 3 groups are 73.2,72.1,and 71.6 respectively.In terms of pathology classification;Xian Yu Tang "group has 14 squamous,11 adenocarcinoma,5 others.Chemotherapy group has 16 squamous,11 adenocarcinoma,3 others. Combination group has 19 squamous,9 adenocarcinoma,2 others.There is no significant difference between these 3 groups in terms of age, average age,PS rating,stage,TCM pathology types,location of tumor before the study.In the "Xian Yu Tang "group,improvements after treatment are very significant with statistical value in Global/QoL,fatigue,vomiting,nausea, dyspnea,appetite loss,and symptoms stated in QLQ-LC13.Improvements in physical function,role function,emotional function,cognitive function, social function,pain,insomnia,constipation,diarrhea and financial difficulty,are also seen after treatment even though the statistical value before and after treatment is insignificant.In the Chemotherapy group,statistical value between before and after treatment is insignificant in physical function,role function,emotional function,cognitive function,social function,Global/QoL,fatigue,pain, vomiting,dyspnea,diarrhea,appetite loss and financial difficulty. Changes in pain and symptoms stated in QLQ-LC13.have statistical significance.In the Combination group,changes between before and after treatment have statistical significance in physical function,emotional function,social function,Global/QoL,fatigue,pain,dyspnea,insomnia,appetite loss,and symptoms stated in QhQ-hC13.There is no statistical significance in role function,cognitive function,vomiting,nausea,constipation,diarrhea and financial difficulty.Compare the changes after treatment between these 3 groups,the statistical value is insignificant in physical function,role function, emotional function,pain,dyspnea,insomnia,constipation,diarrhea, symptoms stated in QLQ-LC13.,local tumorsize,coughing,haemoptysis,chest pain,fever release,kidney and liver functions.Statistical value is significant in cognitive function,social function,Global/QoL,fatigue, vomiting,nausea,appetite loss,financial difficulty,KPS rating,change of body weight,Thirsty,and negative effects on blood.Body weight increase or stable rate is 20%for the Xian Yu Tang "group, 16%for the Combination group,and 11%for the Chemotherapy group.KPS index increase or stable rate is 28%for the Xian Yu Tang "group,27%for the Combination group,and 19%for the Chemotherapy group.Local tumor size CR+PR+CN rate is 18%for the Klan Yu Tang "group,21%for the Combination group, and 17%for the Chemotherapy group.Thirsty improvement is 68%for the Xian Yu Tang "group,35%for the Combination group,and 24%for the Chemotherapy group.Negative effect to the liver function is 0%for the Xian Yu Tang "group, 3.33%for the Combination group,and 13.33%for the Chemotherapy group.Compare the changing value before and after treatment between these 3 groups,the physical function,role function,emotional function,cognitive function,pain,dyspnea,insomnia,constipation,diarrhea,and the symptoms stated in QLQ-LC13 have no significance in the statistical value.The social function,Global/QoL,fatigue,vomiting,nausea,appetite loss and financial difficulty.Have significance in the statistical value.Animal experiment"Xian Yu Tang" in this study indicates that there is a highly statistical significance when the Combine group("Xian Yu Tang" + chemotherapy.)compare with other groups.(P＜0.01).This implies when Chinese medicine is used together with chemotherapy,the curing effect should be better then just solely using Chinese medicine orsolely using chemotherapy.It shows that integration of Chinese medicine and Western medicine is an effective way to cure lung cancer. The Chinese medicine "Xian Yu Tang" increase the expression of TNF-αin the mice with Lewis lung cancer cell in this study indicates the possibility that "Xian Yu Tang" has the function of anti - lung cancer.ConclusionBoth 3 groups in this clinical study can improve the symptoms of lung cancer patients.The combination group has significant improvement to the overall health condition;upgrade quality of life,release fatigue,pain,dyspnea, insomnia and the symptoms stated in QLQ-LC13.The "Xian Yu Tang" group in improvement to the overall health condition,upgrade quality of life, improving fatigue,vomiting,nausea,appetite loss,and financial difficulty has even better results.Also,the "Xian Yu Tang" has no poison or negative effect.In the Animal experiment,the Combine group increase the expression of TNF-αin the mice with Lewis lung cancer cell as compare to other groups. indicates the possibility that "Klan Yu Tang" has the function of anti - lung cancer.The results of this research prove that "Xian Yu Tang" is an effective medicine for the treatment of elderly lung cancer,with the advantages of effective,safe without poison and negative effect,capable to stabilize the size of local tumor,upgrade quality of life forpatients,and at lower cost affordable by most old patients.It should be recommended to extend the application in the treatment of lung cancer.